AIDS Summit Delegates Adopt a Unanimous Call for Action

Times Medical Writer

Delegates from nearly 150 nations at the World AIDS Summit unanimously adopted an AIDS prevention declaration here Thursday amid predictions that governments throughout the world at last will take "urgent action" against the deadly epidemic.

The so-called "London Declaration" is likely to have little immediate impact on the continued global spread of the disease. But officials argued that if the summit's recommendations are adopted by most of the world's nations, the spread of the AIDS virus can be slowed by the end of the year.

"This allows us to be much more optimistic that we can overcome and defeat AIDS," Dr. Halfdan Mahler, director-general of the World Health Organization, said at the conclusion of the three-day health ministers' meeting.

"There has been an unprecedented level of agreement--indeed a universal consensus--that the whole international community must work together," said Tony Newton, British minister for health, who served as the summit president.

The declaration calls on the health ministers to "do all in their power" to assure "urgent action" by their governments against AIDS, including increasing financial resources as well as medical and social support.

With no cure or vaccine in sight, the declaration states that "the single most important component of national AIDS programs is information and education" to change behavior and prevent the spread of the sexually transmitted and blood-borne AIDS virus.

At the summit's closing press conference, Newton was asked if the so-called "London Declaration" would make any difference for the "average man in the street." He, like many of the other 113 health ministers at the meeting, had to concede that there is no tangible544694649international commitment with, for instance, the development of a new AIDS drug or vaccine.

Nevertheless, in international health, such declarations and meetings sometimes pave the way to concrete results. For instance, WHO's centerpiece strategy, "Health for All by the Year 2000," emerged out of a little-noticed meeting at Alma-Ata in the Soviet Union in 1978.

One of Health for All's most successful spinoffs is a global childhood immunization program. Within the last five years, this program has increased vaccination coverage against measles, polio and four other diseases from 5% to 50% of the world's children.

Among those attending the conference was U.S. Surgeon General C. Everett Koop, who told the Associated Press in an interview Thursday that he wanted to screen every student of a major American university this spring to help determine the incidence of AIDS among young adults.

Koop also proposed similar anonymous mass AIDS screenings at a few high schools in the United States, but said the government had made no decision on either proposal.

Koop's proposal could prove controversial. Civil libertarians have argued that anonymous screening is an invasion of privacy and that screening of a limited population could be the forerunner of mandatory nationwide testing.

The surgeon general said health officials had yet to choose a university, but it would likely be one in a large city with a student body of around 25,000. Plans call for the screening to take place sometime this spring, Koop said, and it would likely be part of a one-day open-air campus "gala" on AIDS prevention.

Koop's idea is new, although the Centers for Disease Control in Atlanta has long planned to test college students as part of a series of surveys aimed at measuring the prevalence of AIDS infection in the country. A CDC spokesman said the organization is "developing a project in which there would be a sampling of college students, (which would) almost certainly be done in an anonymous, or blinded, manner." These studies, however, would not be limited to one campus, he said, but would probably be conducted in several areas of the country, most likely in student health clinics.

Over the three-day conference here, more than 100 delegates each gave a five-minute account of AIDS activities in their countries. These "interventions," as such speeches are known in WHO parlance, sometimes seemed as diverse as the number of nations in attendance.

Particularly startling were several presentations that called for quarantine measures against AIDS virus-infected individuals--despite the joint declaration that spoke of the need to avoid such "discrimination" and "stigmatization."

Dr. Hector Molinert of Cuba said his country's policy is to admit AIDS virus-infected individuals to sanitariums. He said there are 174 such Cubans, including 27 people with AIDS and others who were without symptoms.

"The patients in our sanitarium are given comprehensive medical assistance," Molinert said. "They work, receive visits, are paid 100% of their wages, practice gymnastics, sports (and) visit tourist places."

Representatives of Bulgaria and the Soviet Union also spoke of the need to develop internationally recognized AIDS-test certificates, akin to smallpox and yellow fever certificates, to govern international travel and immigration.

Such proposals--to certify individuals as being free of the AIDS virus--have been rejected in the past by WHO officials and many nations as highly ineffective AIDS control measures as well as clearly discriminatory actions.

Some of the bluntest suggestions for how to prevent the spread of the AIDS virus came from Dr. Lone de Neergaard of Denmark's National Board of Health.

"Denmark may be known by some of you as a country with so-called free sex," de Neergaard said. "Some may like this, some may not--but it has been an advantage for us in our battle against AIDS."

He noted that Scandinavian openness about sexual matters made it easier to change the behavior of adolescents and others. "We found that explicit information in the form of pictures, cartoons and video are necessary in order to show exactly what safe sex is."

Dutch health officials spoke enthusiastically about their extensive programs to reach drug addicts who use intravenous needles. About 75% of Amsterdam's addicts take part in methadone treatment, one of the highest such figures in the world.

Dr. Hans Moerkerk, of the city's health education center, also described "positive" results from Amsterdam's controversial program to supply free sterile needles and syringes to drug addicts. He said the number of addicts sharing needles had decreased from 75% in 1985 to 25% in 1987, when 700,000 free needles were distributed.

Times staff writer Marlene Cimons in Washington contributed to this story.

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